What criteria should I use to determine when to refer a patient with alcoholic liver disease to a specialist for further evaluation?

Criteria for referral of a patient with alcoholic liver disease to a specialist include:

• Refer people to a specialist experienced in the management of alcohol-related liver disease to confirm a clinical diagnosis when there is a history of harmful or hazardous drinking with abnormal liver blood test results ².
• Refer people diagnosed with cirrhosis to a hepatology specialist for further management ¹.
• Refer patients with decompensated liver disease (e.g., jaundice, ascites, variceal bleeding, hepatic encephalopathy) for specialist assessment ²,¹.
• Consider referral for liver biopsy if diagnosis is uncertain or to confirm severe alcohol-related hepatitis when corticosteroid treatment is being considered ².
• Refer patients with decompensated liver disease who remain so after best management and 3 months’ abstinence from alcohol for assessment for liver transplantation if otherwise suitable ².